Lucía B. Santos Díaz, MNS
Corresponding email address: luciabsantosdi@gmail.com
Submitted: 7 Jan 2023
Revised: 25 Jan 2023
Accepted: 1 feb 2023
Published: 7 feb 2023
Resumen
La aromaterapia en el manejo de diversas condiciones y patologías es considerada como uno de las practicas más utilizadas en el campo de la naturopatía y es una terapia que se ha expandido rápidamente a nivel mundial. Esta revisión provee una evaluación crítica de los artículos publicados entre el 2002 y 2022 y libros que datan del 1977 que todavía son utilizados en las prácticas de aromaterapia clínica.
Palabras clave: Aromaterapia, Naturopatía, Aromaterapia Clínica, Ciencias Naturopáticas
Abstract
Aromatherapy in the management of diverse ailments and pathologies is one of the most used practices in the naturopathic field and is a fast-growing therapy worldwide. This review provides a critical appraisal of articles published from 2002 to 2022 and books dating back to 1977 that are still used in the clinical aromatherapy practices.
Keywords. Aromatherapy, Naturopathy, Clinical Aromatherapy, Naturopathic Science
Introduction
The National Association for Holistic Aromatherapy (NAHA) defines aromatherapy as the use of natural plant extracts, such as essential oils, hydrosols, and carrier oils, in various ways to heal the body, mind and spirit. It promotes and harmonizes emotional, physical, and spiritual health through the application of these extracts and describes it as both a science and an art (NAHA, n.d). Essential oils on a mental level can enhance the well-being and mood, promote relaxation, and improve concentration and focus. In a Physical level they have antiseptic properties, relieve pain and lower inflammation, have a cleansing action, boost immunity, and influence hormones. On a spiritual level, it can promote spiritual pursuit, enhance mindfulness, energy, and chi (Curtis & Johnson, 2016). According to the National Institutes of Health National Center for Complementary and Integrative Health, Americans spend more than 30.2 billion annually on this therapy and it is predicted that by 2050, the market will grow in spending to $5 trillion (Farrar & Farrar, 2020).
A single essential oil can contain as much as 100 chemical components, which gives the oil its properties along with their aroma. Each oil component divides into two further categories: oxygenated compounds and terpenes. Oxygenated compounds are stronger smelling and long-lasting compared to terpenes and include alcohol, which are antibacterial, antiseptic, and ketones, which regenerate cells. Terpenes, on the other hand, have a range of properties, but spoil quickly when it’s exposed to air (Curtis & Johnson, 2016).
History and Today
The use of aromatic plants has been applied to not only perfume but also to heal the body. Ancient Egyptians revered scents for their cosmetics, medicinal, religious, and embalming practices while the ancient Greeks used them for their massages and baths. Ancient Romans saw scents as a status symbol, spreading the knowledge of these aromatic plants throughout their Empire which led to the use of them during Medieval Europe (Urtnowska-Joppek & Collegium Medicum, 2018). The modern-day terminology of aromatherapy or aromathérapie was created by the French perfumer and chemist, René-Maurice Gattefossé in 1937, when he burned his hand in his laboratory, plunged it in a vat of lavender, and healed without any scarring. This was the event that inspired Dr. Jean Valnet as he treated his patients’ injuries in the military hospital, Margaret Maury who created Holistic Aromatherapy, and Robert Tisserand, who wrote the first book on aromatherapy in English and global specialist in aromatherapy, among others (Urtnowska-Joppek & Collegium Medicum, 2018).
Aromatherapy is used not only in health practices but also in cosmetics and biological regeneration. Properly selected essential oils can alleviate various conditions such as the initial symptoms of a cold in toddlers (Maftuchah, Christine & Hamaluddin, 2020), depression and headaches ((Khenarinezhad, Sharifi Razavi & Bagheri-Nesami, 2019) , dysmenorrhea (Widarti, Itha & Lusiana, 2021), fibromyalgia (Ko, Hum, Tratses & Berbrayer, 2007), neuropathic pain in diabetic patients (Rivaz, Khademiam & Dabbaghmanesh, 2021), promote a better the quality of life in cancer patients (Coquel Bru, Alvear Sedán, Severiche Sierra, Caceres Matta, Vidal Tovar, Ruiz Cabezas, Martínez Zabaleta & García Moreno, 2019), among other pathologies. It can also be used to manage postoperative pain (Kim, Wajda, Cuff, Serota, Schlame, Axelrod, Guth & Bekker, 2006) as well as post-anesthesia (Kim, Ren, Fielding, Pitti, Kasumi, Wajda, Lebovits & Bekker, 2007).
Administration of Essential Oils
There are four (4) basic methods that are commonly used in the administration of essential oils: topical, inhalation, oral, and internal absorption (Farrar & Farrar, 2020). The topical application can be applied in massage sessions, scented baths, cosmetics, and perfumes, keeping in mind the dilution of the oils with a base oil which are commonly made of seeds and nuts. The oils pass through the epidermis, sebaceous glands, and hair follicles which, in turn, goes straight to the capillaries and bloodstream, leading to the oils running their course through the body systems via circulatory systems (Urtnowska-Joppek, MSC & Collegium Medicum, 2018) as shown in Figure 1.1. It is important to emphasize the need of doing patch tests on the patients who have hypersensitive skin, any dermatological pathology, or allergies.
Inhalations can include direct inhalation via diffuser with steam, aroma stones, oil-scented strips of cloth while indirect inhalations could be the usage of essential oils in scented room sprays, heated candle wax, detergents, and bathroom and floor cleaners. When inhaled, the various aromas penetrate the blood via the lungs, causing physiological and behavioral changes (Herz, 2009). In turn, the limbic system, which controls our emotions and memories, is triggered (Thomas, V. edD, ARNP & CS, 2002) as shown in Figure 1.1.
Oral absorptions of essential oils are provided using gelatin capsules with safe dosages of essential oils that are diluted with base oils (Farrar & Farrar, 2020). Although the U.S. Food and Drug Administration (FDA) records 160 essential oils, oleoresins, and distillates that are considered safe for human consumption on the Generally Recognized as Safe list (GRAS) adding further evidence that some essential oils are harmless when taken orally (CAF, n.d.). It is essential to know which are the accepted essential oils and the required dosages that can be given to the patient. Lastly, the internal absorption of essential oils can be given through a scented mouthwash, scented suppositories, or vaginal douches. Some essential oils are used to flavor prescription medications as well as herbal medicines (Farrar & Farrar, 2020).
Figure 1.1 Routes of Penetration of Essential Oils into the Human Organism
Evidence on the Use of Common Essential Oils
As mentioned before, essential oils are used every day for their aromatic scents, over-the-counter herbs and added to medications to add a pleasant flavor to bitter medications. Although the usage of essential oils is common in naturopathic and complementary practices, it is essential to learn about the indications and contraindications of each oil that is provided to their patients. The following table is a summary of basic essential oils that are commonly found in naturopathic and complementary practices worldwide.
Adulteration of Essential Oils
As a practitioner of aromatherapy, it is imperative to know that there is a lack of regulation about the chemical composition of essential oils which create a need of accurate characterization of oils from their manufacturers (Dubnicka, Cromwell & Levine, 2020). Investigations have pointed out a significantly under-reported health concern from inhaling toxic contaminants such as Carbitol, Diethyl Phthalate in store brand essential oils.
Italian study using fast GC/MS and HPLC analysis indicate that herniarin isopimpinellin, and 5-heranyloxy-8-methoxypsoralen, normally found in lime oil, was found in lemon oil. The study states that “experimental results shown in this study demonstrate that fast-GC/MS and HPLC remain one of the most effective means to detect these illegal modifications” (Marti, Boccard, Mehl et al., 2014).
Because of shortages and sustainability issues, some companies that create essential oils have added endocrine disruptors, toxic inhalants, among other unnecessary chemicals that affect the original chemical component of essential oils. It is imperative to create technical methods to authenticate the oils for the benefit of those who are applying aromatherapy to their healthcare practice.
Conclusión
Aromatherapy is used in naturopathic and complementary practices worldwide because it is a cost-effective symptom manager (Farrar & Farrar, 2020) and it is effective in some pathologies. On the flip side, because of how accessible they are, it can also be dangerous and toxic since essential oils can be flammable, phototoxic, adulterized with unwanted chemicals, and can cause oral toxicity and even death if it is not applied correctly. As healthcare professionals, it is imperative to educate ourselves and be selective for a clinical aromatherapy practitioner course and educate our patients on finding the appropriate essential oil to avoid any contaminations, how to dilute them, the contraindications, and safety precautions while they are applying aromatherapy on themselves.
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